PROJECT SUMMARY (Sea instructions): Project 2: Late Stage Lung Cancer focuses on Stages Illb-IV unresectable lung cancer within a program project with central themes related to palliative care, quality of life (QOL), and symptom management. This project focuses on Late Stage Lung Cancer, a population who have decreased survival and high QOL and symptom concerns. The aims of the research are: Aim1: Test the effects of the Palliative Care Intervention (PCI) on overall QOL and psychological distress for patients with Late (Stage Illb-IV) non-resectable NSCLC compared to a group receiving usual care. Aim 2: Compare symptom control in the PCI group versus the usual care group in Late Stage NSCLC. Aim 3: Compare geriatric assessment outcomes (OARS Instrumental Activities of Daily Living, MOS Activities of Daily Living, MOS Social Activities Limitation Scale, Hospital Anxiety and Depression Scale scores, and the Karnofsky Performance Scale) in the PCI group versus the usual care group. Aim 4: Test the effects of the PCI on resource use as compared to the usual care group. Aim 5: Identify subgroups of patients who benefit most from the PCI in relation to sociodemographic characteristics, treatment factors, and geriatric assessment predictors at the 12 week primary end point. A two-group, prospective sequential, quasi-experimental, tandem enrollment design (N=326) will be used for this project, in which the usual care group is accrued and followed during Phase 1 and the intervention group is accrued and followed during Phase 2. The proposed PCI intervention combines pre-treatment assessment and goal setting through the collaboration of an interdisciplinary team. The Palliative Care Intervention is based on pilot work completed from 2005-2007 by the investigators documenting needs of lung cancer patients and testing the intervention. This project has great significance to public health given the significant numbers of people diagnosed with lung cancer and the associated individual and societal costs.